Alveolar Bone Loss, Alveolar Bone Preservation, Bone Resorption, Concentrated Growth Factors, Immediate Dental Implant Placement, Socket Shield Technique, Xenograft
Conditions
Keywords
immediate implants, socket shield technique, Concentrated growth factor, Xenograft
Brief summary
This prospective case series aims to evaluate the clinical and radiographic outcomes of immediate implant placement using the socket shield technique combined with concentrated growth factors (CGF) and xenograft in the esthetic zone. The study will assess crestal bone level changes and implant stability over a 6-month follow-up period.
Detailed description
This study is designed as a prospective case series to evaluate the effectiveness of combining concentrated growth factors (CGF) and xenograft with the socket shield technique (SST) during immediate implant placement in the maxillary esthetic region. Post-extraction alveolar ridge resorption, particularly of the buccal bone plate, represents a significant challenge in achieving optimal esthetic outcomes. The socket shield technique has been introduced to preserve the buccal bone by retaining the labial portion of the root, thereby minimizing post-extraction resorption. However, immediate implant placement is often associated with the presence of a gap between the implant surface and the socket wall, known as the "jumping gap," which may compromise implant stability and osseointegration. To enhance bone regeneration within this gap, bone grafting materials are commonly utilized. Concentrated growth factors (CGF), an autologous platelet concentrate, have demonstrated the ability to promote angiogenesis, osteogenesis, and soft tissue healing through the sustained release of growth factors. When combined with xenograft, which provides an osteoconductive scaffold, this approach may improve bone regeneration and implant integration. In this study, eligible patients requiring immediate implant placement in the esthetic zone will undergo partial extraction therapy using the socket shield technique. Implants will be placed immediately after extraction, and CGF will be prepared from the patient's venous blood and mixed with xenograft to form a "sticky bone" graft, which will be applied to fill the jumping gap. Radiographic evaluation will be performed using cone-beam computed tomography (CBCT) at 2 weeks and 6 months postoperatively to assess crestal bone level changes. Implant stability will be measured using resonance frequency analysis (Osstell device) and expressed as implant stability quotient (ISQ) values. The findings of this study are expected to provide clinical and radiographic evidence regarding the effectiveness of combining CGF and xenograft with the socket shield technique in enhancing bone regeneration and improving outcomes of immediate implant placement in the esthetic zone.
Interventions
PROCEDURESocket Shield Technique with Immediate Implant Placement and CGF + Xenograft
The procedure involves partial extraction therapy using the socket shield technique, where the buccal portion of the root is preserved to maintain the alveolar bone. Immediate implant placement is performed into the extraction socket. Concentrated growth factors (CGF) are prepared from the patient's autologous blood via centrifugation and combined with xenograft to form a "sticky bone" graft. This graft is placed in the jumping gap between the implant and socket wall to enhance bone regeneration and healing. Implant stability will be measured using resonance frequency analysis (Osstell), and radiographic evaluation will be performed using CBCT.
Sponsors
Cairo University
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age ≥18 years old. (Younis, W., \& El-Rashidy, A. 2020). * Both male and female patients. * Maxillary, anterior and premolar segments.
Exclusion criteria
* A medical history that contraindicates oral surgical treatment such as (uncontrolled/untreated diabetes mellitus, immuno-compromised status, radio or chemotherapy of the oral and maxillofacial region, treatment with oral and/or intravenous bisphosphonates). * Presence of active or untreated periodontal disease. * Vertical root fractures involving the buccal aspect. * Tooth /teeth with horizontal fractures below bone level. * Tooth /teeth with external or internal resorption. * Patients with destructive oral habits such as smoking, chewing tobacco, bruxism, etcetera.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| crestal bone level | 2 weeks, and 6 months postoperatively | Evaluation of changes in crestal bone level around the dental implant using cone-beam computed tomography (CBCT). Measurements will be taken from a fixed reference point on the implant to the first bone-to-implant contact recorded in millimeters (mm) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Implant Stability (ISQ Values) | Immediate postoperative, and at 6 months | Implant stability will be assessed using resonance frequency analysis with the Osstell device and recorded as Implant Stability Quotient (ISQ). ISQ values range from 1 to 100, where higher values indicate greater implant stability and a better outcome. |
Countries
Egypt
Contacts
CONTACTHuda Ayman Alrifai, bachelors
STUDY_CHAIRTarek I.A El-Ghareeb, PHD Holder
Cairo University
STUDY_DIRECTORAbdelmoez Mohamed EL-Sharkawy, Associate professor
Cairo University
Outcome results
None listed